Transcatheter aortic valve replacement with next-generation self-expanding devices: a multicenter, retrospective, propensity-matched comparison of evolut pro versus acurate neo transcatheter heart valves
JACC cardiovasc. interv
; 12(5): 433-443, Mar. 2019. tabela, gráfico
Artigo
em Inglês
| Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1024526
Biblioteca responsável:
BR79.1
Localização: BR79.1
ABSTRACT
Abstract OBJECTIVES:
The aim of this study was to compare transcatheter aortic valve replacement (TAVR) with the Acurate neo (NEO) and Evolut PRO (PRO) devices.BACKGROUND:
The NEO and PRO bioprostheses are 2 next-generation self-expanding devices developed for TAVR.METHODS:
The NEOPRO (A Multicenter Comparison of Acurate NEO Versus Evolut PRO Transcatheter Heart Valves) registry retrospectively included patients who underwent transfemoral TAVR with either NEO or PRO valves at 24 centers between January 2012 and March 2018. One-to-one propensity score matching resulted in 251 pairs. Pre-discharge and 30-day Valve Academic Research Consortium (VARC)-2 defined outcomes were evaluated. Binary logistic regression was performed to adjust the treatment effect for propensity score quintiles.RESULTS:
A total of 1,551 patients (n = 1,263 NEO; n = 288 PRO) were included. The mean age was 82 years, and the mean Society of Thoracic Surgeons score was 5.1%. After propensity score matching (n = 502), VARC-2 device success (90.6% vs. 91.6%; p = 0.751) and pre-discharge moderate to severe (II+) paravalvular aortic regurgitation (7.3% vs. 5.7%; p = 0.584) were comparable between the NEO and PRO groups. Furthermore, there were no significant differences in any 30-day clinical outcome between matched NEO and PRO pairs, including all-cause mortality (3.2% vs. 1.2%; p = 0.221), stroke (2.4% vs. 2.8%; p = 1.000), new permanent pacemaker implantation (11.0% vs. 12.8%; p = 0.565), and VARC-2 early safety endpoint (10.6% vs. 10.4%; p = 1.000). Logistic regression on the unmatched cohort confirmed a similar risk of VARC-2 device success, paravalvular aortic regurgitation II+, and 30-day clinical outcomes after NEO and PRO implantation.CONCLUSIONS:
(AU)
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Coleções:
Bases de dados nacionais
/
Brasil
Base de dados:
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Assunto principal:
Substituição da Valva Aórtica Transcateter
Tipo de estudo:
Ensaio clínico controlado
/
Fatores de risco
Limite:
Humanos
Idioma:
Inglês
Revista:
JACC cardiovasc. interv
Ano de publicação:
2019
Tipo de documento:
Artigo
Instituição/País de afiliação:
Cardio Center Humanitas Research Hospital/IT
/
Cardiovascular Institute University Hospital Clinic IDIBAPS/ES
/
Center Erasmus Medical Center, Rotterdam/NL
/
Centre for Heart Valve Innovation St. Paul's and Vancouver General Hospital/CA
/
Contilia Heart and Vascular Centre Elisabeth Krankenhaus Essen/DE
/
Department for Percutaneous Treatment of Structural Heart Disease Albertinen Heart Center/DE
/
Department of Heart Center Bonn University Hospital Bonn/DE
/
Department of Cardiology C.A.S.T. Policlinic G. Rodolico Hospital/IT
/
Department of Cardiology Galway University Hospitals/IE
/
Department of Cardiology Hospital of León/ES